Individual
JESUS HERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 669-5869
(401) 762-3774
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 669-5869
(401) 762-3774
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
10766
RI
2084N0400X
Neurology Physician
Primary
12102
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511099
—
NV
05
—
1982618476
—
NV
05
—
7009548
—
RI
Enumeration date
07/28/2006
Last updated
02/14/2014
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